ASSOCIATION OF OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES WITH IMPAIRED FUNCTIONAL STATUS
ASSOCIATION OF OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES WITH IMPAIRED FUNCTIONAL STATUS
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DOI：
10.1016/0002-9343(93)90210-g
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发表时间：
1993-06-01
影响因子：
5.9
通讯作者：
MULHAUSEN, PL
中科院分区：
文献类型：
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作者：
LYLES, KW;GOLD, DT;MULHAUSEN, PL
目得：为了确定老年妇女的椎体压缩性骨折是否与身体，功能和心理社会performance.SubjecTS和METHODS：10个白色妇女证实椎体压缩性骨折的损害与年龄和种族匹配的10个对照组无骨折的病例对照设计。受邀参加本研究的所有受试者均为杜克大学医学中心医学系老年科的患者。所有研究参与者都住在社区或在达勒姆，NC当地退休社区的独立生活部分。骨折患者（平均年龄= 81.9岁，标准差= 0.5岁）的病历中有两处或两处以上椎体压缩性骨折，而对照组（平均年龄= 79.6岁，标准差= 6.5岁）无椎体骨折病史。所有女性的脊柱X线片证实了分组。通过测量最大躯干伸展扭矩和矢状面中的胸椎和腰椎运动、功能性伸展、移动技能、10英尺定时步行和6分钟步行试验来评估体能。还确定了胸椎和腰椎的结构。使用功能状态指数评估功能性能。社会心理表现采用以下量表进行评估：霍普金斯症状自评量表90修订版、Rosenberg自尊量表、West Haven-Yale疼痛量表、Beck抑郁量表和单项健康信念问题。对照组受试者与骨折患者在年龄、体重、当前疾病数量、处方药数量、止痛药数量、腰椎退行性椎间盘疾病或腰椎小关节炎的评级。两组的活动水平和运动参与度相似。对照组受试者没有椎骨骨折，而骨折组受试者有4.2 +/- 2.6处骨折（范围：2至10处）。骨折患者胸椎后凸增加，腰椎前凸减少。骨折受试者的最大躯干伸展扭矩、胸椎和腰椎矢状面运动、功能伸展、活动技能和6分钟步行试验均降低。功能状态指数显示，骨折受试者的功能表现水平降低，与对照组相比，辅助水平增加，活动疼痛和活动困难。心理社会性能是有限的骨折科目增加精神症状，增加疼痛，更大的感知问题所造成的health.CONCLUSION：椎体压缩性骨折与显着的性能障碍，在身体，功能和心理社会领域的老年妇女。
PURPOSE: To determine if vertebral compression fractures in elderly women were associated with impairments in physical, functional, and psychosocial performance.SUBJECTS AND METHODS: Ten white women with confirmed vertebral compression fractures were age- and race-matched with 10 control subjects without fractures in a case-control design. All subjects invited to participate in this study were patients of the Geriatrics Division of the Department of Medicine at Duke University Medical Center. All study participants lived either in the community or in the independent-living sections of local retirement communities in and around Durham, NC. Subjects with fractures (mean age = 81.9 years, SD = .5 years) had two or more vertebral compression fractures in their medical records, whereas control subjects (mean age = 79.6 years, SD = 6.5 years) had no history of vertebral fractures Spinal radiographs of all women confirmed group assignment.Physical, functional, and psychosocial performances were evaluated. Physical performance was assessed by measurements of maximal trunk extension torque and thoracic and lumbar spinal motion in the sagittal plane, functional reach, mobility skills, 10-ft timed walk, and 6-minute walk test. Thoracic and lumbar spinal configurations were also determined. Functional performance was assessed using the Functional Status Index. Psychosocial performance was assessed with the following scales: Hopkins Symptom Checklist 90 Revised, Rosenberg Self-Esteem Scale, West Haven-Yale Pain Inventory, Beck Depression Inventory, and single-item health-belief questions.RESULTS: Control subjects were not significantly different from patients with fractures in age, weight, number of current illnesses, number of prescribed medications, number of pain medications, ratings of lumbar spine degenerative disc disease, or lumbar spine facet joint arthritis. Activity levels and exercise participation were similar in both groups. Control subjects had no vertebral fractures, whereas fracture subjects had 4.2 +/- 2.6 fractures (range: 2 to 10). Thoracic kyphosis was increased and lumbar lordosis was reduced in fracture subjects. Fracture subjects had reduced maximal trunk extension torque, thoracic and lumbar spine sagittal plane motion, functional reach, mobility skills, and 6-minute walk test. The Functional Status Index showed reduced levels of functional performance in fracture subjects compared with controls with increased levels of assistance, pain with activity, and difficulty in activities. Psychosocial performance was limited in fracture subjects with increased psychiatric symptoms, increased pain, and greater perception of problems caused by health.CONCLUSION: Vertebral compression fractures are associated with significant performance impairments in physical, functional, and psychosocial domains in older women.